POSTOPERATIVE PAIN THERAPY DURING HOSPITA L STAY

Pain therapy is a central medical task and a legal duty. Not the anaes thetist but the pain-causing surgeon is responsible for therapy of pai n. Pain as a negative sensation is subjective and individual. Postoper ative pain is an essential aspect of the topic ''pain in surgery''. Th erapy starts with the awareness of the problem. Effective pain therapy requires clinical competence and application of available therapeutic options. Initial steps of successful pain treatment include: an infor mative dialogue with the patient, conveying of confidence, and skilful choice of diagnostic and/or therapeutic options. Application of drugs presupposes detailed knowledge of their specific effects. For convinc ing therapeutic results, one has to analyse different causes of pain. Acute surgical pain is classified and treated according to a three-ste p scheme: intense pain with strong opioids, intermediate pain with wea ker opioids or non-opioids, and slight pain with non-steroidal anti-in flammatory drugs. Opioids are used with caution in abdominal surgery b ecause of their negative effects (obstipation), the same is the case w ith Novalgin in trauma patients because of its effect on temperature a nd leukopenia. Patient-controlled analgesia with appropriate devices m eans further progress for suitable patients. Effective pain therapy wi thin the framework of successful surgery is feasible and influences pa tients' comfort and possibly even their morbidity and mortality.